Addiction: You Choose
As human beings, we possess an extraordinary ability to exercise free will. Every day, the choices we make directly impact the course of our lives. From the moment we open our eyes in the morning to the time we close them at night, we are faced with a multitude of decisions that we must make. Even the decision to refrain from making a choice is still a choice in itself. This fact can be empowering, as it means that we have the power to create the life we want through our choices. However, it also means that we must take responsibility for the consequences of those choices.
Addiction is not a chronic disease but a rational choice process. While addiction is a complex issue that may involve a variety of factors, at its core, it is a choice that a person has made. Recognizing this fact is a crucial step in overcoming addiction and taking control of one's life. The National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recognize addiction as a chronic illness that affects the brain and can result in relapses, much like other chronic diseases such as diabetes, asthma, or heart disease.
Drug addiction: Is it a disease or a choice? Marc Branch's review of Gene Heyman's book 'Addiction: A Disorder of Choice' (2011) discusses Heyman's perspective. Heyman suggests that addiction can arise from typical and fundamental decision-making processes, and individuals do not necessarily choose to become addicts. Rather, a typical decision-making process can lead to addiction. Heyman believes that choice-by-choice contingencies play a crucial role in determining an individual's choices, rather than the outcome of sequences of choices. Although some people argue that genetic factors contribute to addiction, Heyman acknowledges genetic contributions but asserts that they are not a reliable basis for concluding that drug abuse is a disease process. According to Branch (2011), Heyman's theory is as follows:
“That addiction is tied to changes in brain structure and function is what makes it, fundamentally, a disease.” (Leshner, 1997, p. 45) The logic of this statement is obviously fallacious, as Heyman is quick to point out. Any persistent change in behavior is going to be associated with changes in the central nervous system because the nervous system participates in behavior. One might as well conclude, say, that reading is a disease because the brains of readers necessarily differ from those of nonreaders. (pp263–267)
Scientists have discovered techniques that can predict self-defeating and selfish behavior patterns. These laws of choice predict how different species, including humans, choose between different commodities and activities. The relevance of these laws to addiction and other self-defeating behaviors is that they predict stable yet suboptimal patterns of behavior. A common feature of addictive drugs is that they provide immediate benefits but delayed costs. Scores of studies support the analysis that persistent drug use reflects the workings of a local optimum, whereas controlled drug use or abstinence reflects the workings of a global optimum.
In the past, addiction studies were limited to individuals who had been incarcerated, such as detoxification, in American prisons, hospitals, or similar institutions. These studies typically included individuals with extensive criminal records, limited work experience, low-cost marriage rates, and lower-than-average education. As a result, the understanding of addiction as a chronic illness was based on a sample of drug users whose demographic characteristics are now known to be comparable to the factors that make quitting difficult.
However, the 1960s saw the emergence of drug addiction among college campuses and affluent neighborhoods, and addiction began affecting individuals from all walks of life, including those who were employed, married, and highly educated. Consequently, the natural history of addiction shifted, with family, work, and the difficulties of an unlawful lifestyle often causing the desire to become high. Contrary to popular belief, every major epidemiological study conducted over the past 30 years reflects this reality. Studies have demonstrated that addiction is no longer confined to a specific demographic, and individuals from all backgrounds can be affected. Furthermore, these studies have demonstrated that quitting drugs is not just a matter of willpower, but rather it is a complex process that requires extensive medical assistance, counseling, and support from family and friends. By recognizing the changing nature of addiction and adopting a more holistic approach to treatment, we can assist those struggling with addiction to overcome their challenges and lead wholesome, gratifying lives.